HomeMy WebLinkAbout18-9-5 Signed application--� HARBOR PER ITT
r TRANSFER APPLICATION
100 Civic Center Drive
�.. Lc -.,,-port Beach, CA 92W
r 949-644,-3044
"'Date of Applicaton:S
Permit
Number
"Property Address:
2
a ..
"Buyer's Names: _ZT05A � .AC - off.
Buyer's Signatures _ --
Billing Address 14i20 Ve _�34
--
Telepl,on,e No ( 2-4 - Z3a - 01 t
""Seller's Names:
Seller's Signatures: _ -1 ;e�_e - ---
Joint Owner Signature.
"Escrow Company: _Phone#
"Ad d ress an 1 C 1,
'Escrow Number: `x ax
Closing Date (Estimate j Email: ;1
= *STARRED ITEMS MUST BE COMPLETE TO BEGIN THE PROCESS.
Inspection Date Reinspect;or. Date -
Fee Paid heck No
Application Complete.
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INSPECTION FORM
Harbor resources Department
Date -
Inspection Requested By:
Inspector,
Pier Address -
Pier Transfer
GFI Present
Anti-Sip-hon I Backflow Present
Other Comments
Pump Out
Pier Location
Ye- Need None Needed
' I
Yes No
Operational -
Recommended Action
Encroachment
Address of Complaining Party
Boat Description
CF Number
I_ocatior. or, Dock
uommerts ( Obsepiations
Reinspection
Yes Need
0t-her Raquesti